Neurocerebrovascular diseases like cerebrovascular infarction, stroke, ischemic attacks etc. are caused by an interruption of the blood supply resulting from disease of the arteries carrying blood to the brain.
Of the three general types of stroke,cerebral hemorrhage is caused by rupture of a blood vessel with bleeding into the brain (intra cerebral hemorrhage) or under its covering membrane, while cerebral thrombosis stems from obstruction of a cerebral blood vessel when a blood clot forms within the walls.
The clot may be caused by abnormal thickening of the blood, damage to the vessel wall from arteriosclerosis, atherosclerosis, inflammation of the arteries or inflammation of the veins.
If the blood supply is stopped completely or is reduced to less than one-fourth its normal level, softening of the brain (cerebral infarction) results, causing permanent brain damage.
Cerebral embolism is obstruction of a cerebral artery by a blood clot or a foreign body migrating from another part of the body's circulation like when a clot that has formed on the inside wall of one of the arteries in the neck travels up to the brain and blocks a major artery branch.
Trasient ischemic attacks (TIAs) are brief episodes of symptoms caused by temporary interruptions of the blood supply. Reversible ischemic neurological deficits(RINDs) are small cerebral infarction. Multiple cerebral infarction can lead to permanent confusion and memory loss. Ischemic stroke is a medical emergency. After TIAs or stroke occur, treatment may be surgical or medical. Surgery may be needed in some cases to remove any blockage of blood vessels going to the brain.
Medication can prevent the formation of blood clots on the atherosclerotic plaques within the vessel wall. Brain swelling commonly accompanies brain infarction or hemorrhage. No satisfactory treatment is available.
Currently used drugs in perpheral vascular and cerebral disorders include ergot alkaloids, aspirin, anti-coagulants etc. The latter are used following strokes to prevent further cerebrovascular incidents but their use is contraindicated if the stroke was the result of hemorrhage.
The use of TICLOPIDINE, a highly effective antiplatelet agent to treat stroke cases is restricted in its long term use due to its adverse side-effects. Tissue plasminogen activator (t-PA) used to treat clots in the coronary arteries (acute heart attack), is a natural clot dissolving substance produced by the body which can blow open a blood clot in the brain that causes the acute ischemic brain damage characteristic of a stroke. While t-PA can dissolve the blood clot that causes a blood vessel blockage, there are other complications which occur during ischemic stroke which must be addressed if permanent brain damage is to be prevented. It is critically important to have nitric oxide (NO) and superoxide scavengers in the blood stream when t-PA is administered to reduce the free radical damage that will occur when the blood flow is restricted and even more when the flow is resumed.
Nitric oxide(NO) and superoxides inflict damage on important biomolecules and their increased production has been implicated in human diseases like cerebro-,cardiovascular, inflammatory, neurological dysfunctions and cancer etc.[Onoda M., Inano H., Nitrc oxide: Biology and Chemistry, 4, (5), 505-515 (2000)].
Most strokes culminate in a core area of cell death (infarction) and the blood flow is so drastically reduced that the cells usually can not recover. Brain cells die as a result of the actions: calcium activated proteases (enzymes which digest cell proteins), lipases (enzymes which digest cell membranes) and free radicals formed as a result of the ischemic cascade. Without neuroprotective agents, nerve cells may be irreversibly damaged within several minutes. Any disruption of blood flow to the brain causes massive free radical damage that induces much of the reperfusion injury to brain cells, typical of strokes. When blood flow is interrupted and subsequently restored (reperfused), tissues release iron that acts as a catalyst for the formation of free radicals that often permanently damage brain cells. Protecting brain cells from injury caused by blood flow disruption, therefore, is of prime importance. If an ischemic stroke is happening, the use of large quantities of anti-oxidants like melatonin, vitamins and herbs like Ginkgo biloba have been suggested to provide some benefit. Magnesium in an oral dose of 1500 mg. is a safe nutrient to relieve an arterial spasm, a common problem in thrombotic strokes.
The ancient Indian system of medicine-Ayurveda—is concerned with the prevention, diagnosis and cure of disease. The word “dis-ease”—a right translation of illness is viewed as a dysfunction of the whole body and is attributed to the circulation and transformation of ubiquitous humoral fluids.
Most of the Ayurvedic drugs are products of high repute which act on a number of dysfunctions of the body involving various organs and aim at preventing problems or restoring a normal situation, and try to recover the patient completely. Evolved over a long period of time and experimentation, they are the results of a particular combination of certain fundamental elements which determine their properties which in turn are responsible for the chemical, biological or therapeutic effects of those substances. There is no substance when correctly prepared which can not be used as remedy.
Ayurveda describes a number of beneficial effects of rhizomes and leaves of various species belonging to zingiberaceae family, especially those of Curcuma longa L.syn. Curcuma domestica Valeton, rhizomes and leaves popularly known as Turmeric or Haldi. Prominent among these are the anti-bacterial, antifungal wound healing and the anti-inflammatory actions which enabled turmeric paste to be used as a house hold remedy to treat wounds and inflammation.
In recent years, its constituents-Curcumin and other curcuminoids have been found to exhibit besides these activities, choleretic, cholagogic, anti-oxidant, anti-cancer, inhibition of leukotriene biosynthesis, 5-lipoxygenase, cyclo-oxygenase, lipid peroxidation, superoxide and nitric oxide (NO) scavenging effects. Turmeric—a highly reputed herb in Indian system of medicine-Ayurveda-is the rhizome of Curcuma longa L.Syn. Curcuma domestica Valeton (Fam. Zingiberaceae) which grows abundantly in India. It has long been used as a spice and a colouring agent in food as well as a naturally occurring medicine. Its powder or extracts are recommended to treat wounds and inflammation.
A major constituent Curcumin was developed as an anti-inflammatory agent [Srimal R. C., Khanna N. M., Dhawan B. N., Ind. J. Pharmacol., 3, 10 (1971)]. Other therapeutic properties of Curcumin, various curcuminoids and some other constituents of Curcuma species include anti-bacterial, anti-fungal [Schraufstatter F., Brent H., Nature, 164,456(1949), Arch. Dermatol.u.Syphilis, 188,250 (1949); Lutomski. J., KedziaB., Debska W, Planta Med., 26, 9 (1974); Rao B. G. N., Joseph P., Reichst, Aromen Koerperflegem, 21, 405-406(1971); Swada T., Yamahara J., Shimazu S., Ohta T., Shoyakugaku Zasshi, 2, 11-16(191), Prasad C. R., Sirsi M., J. Sci. Ind. Res., C. 15, 239-41(1957); Schraufstatter E., Deutsh. S. Z. Naturforsch. 4, 276 (1949); Chopra R. N., Gupta J. C., Chopra G. S., Ind. J. Med. Res., 29, 769-72 (1941)], anti-oxidant [Ramaswamy T. S., Baneijee B. N., Ann. Biochem. Exp. Med., 8, 55 (1948); Chipault .J. R., Mizuno G. R., Lundberg W. O., Food Res., 10, 209, (1956)]; inhibition of lipid per-Oxidation [Sharma S. C., Mukhtar H., Sharma S. K., Krishnamurty C. R., Biochem. Biopharmacol., 21, 1210-14 (1972); Zu S., Tang. X. Lin Y., Zhougcuoyev., 22, 264-5(1991); Sharma O. P., Biochem. Biopharmacol. 25, 1811(1976)]; active oxygen species scavenging and prevention of increased free radical formation by Curcumin in the body [Tennesen H. H., Inter. J. Pharmacol., 50, 67-69(1989), Kunchandy E., Rao M. N. A., Inter. J. Pharmacol., 58, 237 (1990)]; inhibitory activity for iNOS induction by lipopolysacchande in the mammary gland and scavenging activity for NO radicals by Curcumin, [Onoda M., Inano H., Nitric Oxide: Biology and Chemistry, 4, 505-515 (2000)], anti-inflammatory [Arora R. B., Basu N., Kapoor V., Jain A., Proc. Second Indo Soviet Symposium on Natural Products, New Delhi, 1970, p. 170., Ind. J. Med. Res., 59, 10 (1971); Mukhopadhya A., Basu N., Ghatak N., Singh K. P., Gujral P. D., Proc. Int. Union of Physiol. Sci., 11, 241(1974); Ghatak N. N., Basu N., Ind. J. Exp. Biol., 10, 235 (1972), Chandra D., Gupta S. S., Ind. J. Med. Res., 60, 138-142 (1972)]; anti-cancer [Soudamini K. K., Kuttan R., J. Ethnopharmacol. 27, 227 (1989); Kuttan R. Bhanumatty P., Nirmala K., George M. C., Cancer Lett., 29, 197 (1985)]; antioxidant and antitumor promotor which induces apoptosis in human leukemia cells [Rao M. L., Huang T. S., Lin J. K., Biochem. Biophysic. Acta, 1817, 98-100(1996)], inhibition of cell growth in chinese hamster ovary cell culture and cytotoxicity to lymphocytes and Dalton's lymphomaCells., [Cancer Lett. (Ireland), 29, 197 (1985) via Chem. Abstr. 104, 61654d (1986)], tumor protecting activity in mouse skin carcinogenesis induced by 7, 12-dimethyl benz (a) anthracene [Kyoto-Furiton Doigaku Zasshi, 96, 725 (1987)-via Chem. Abstr., 107, 211555a (1987)], inhibition of HIV protease [Suz Luz, Craik C. S., Oritz T., Montanello P. R., Proc. 205, ACS National Meeting, Denver, Colo., 28 March-2 April, Amer. Chem. Soc. Med. Chem. Div. (1993), Take Y., Inoyya H., Nakamura S., Alauddin H. S., Kuba A., J. Antibiot., 42, 107-118 (1989)], inhibition of lipoxygenase, cyclooxygenase [Tennesen. H. H., Int. J Pharmacol., 50., 67 (1989), inhibition of ADP-epinephrine and collagen induced platelet aggregation, [Srivastava R., Puri V., Srimal R. C., Dhawn B. N.; Arznei Forsch., 36, 715-717(1986)]; protection against thrombotic challenge [Srivastava R., Dixit M., Srimal R. C., Dhawan B. N., Thromb. Res., 40, 413-17(1985)]; reduction in ratio of total cholesterol/phospholipids in hyperlipidemic rats and elivated HDL-cholesterol and total cholesterol ratio [Ind. J. Physiol. Pharmacol., 32, 299 (1988)]; anticoagulent activity [Chem. Pharm. Bull., 33, 1499 (1985)]; inhibition of platelet aggregation, metabolic disorders and hyperlipidemia [Lin Y., U.S. Pat. No. 4,842,849; Chem. Abstr., 111, 160200 (1984); Khanna N. M., Sarin J. P. S., Singh S., Pal R., Seth R. K., Nitya Nand S., Indian Patent 162441(1984)]; which makes it useful to prevent cardiovascular disorders like ischemic heart attacks, myocardial infarction etc. In Indo-China region, Curcuma extracts are given at parturition on account of their anticoagulent action. Ethyl p-methoxy cinnamate isolated from Curcuma rhizomes essential oil exhibit antifungal activity [Herba Hung., 28, 95(1989), via Chem. Abstr. 111, 191496j (1989)], while furanogermenone and (4S,5S) (+) germacrone 4,5-epoxide also isolated from Curcuma rhizomes essential oil exhibits anti-inflammatory and preventive effect against stress ulceration [Yakugaku Zasshi, 106, 1137 (1986), Chem. Abstr. 106, 95935c (1987); Zhongyao Tungbto, 10, 134 (1983), Chem. Abstr. 103, 115886d(1985)]. The other reputed herb from Zingiberaceae family, Zingiber officinale Rosch, exhibits preventive effects in heart attack or stroke [Srivastava K. C., Prostaglandins Leukotrienes and Medicines, 13,227-235(1964)].